Effect of e-Cigarettes Plus Counselling vs Counselling Alone on Smoking Cessation: A Randomized Clinical Trial
RCT (n=376) found higher smoking abstinence rates for nicotine e-cigarettes plus counselling vs counselling alone at 12 weeks, but the difference was no longer significant at 24 weeks. Trial interpretation is limited by early termination and further research is needed.
Source:
Journal of the American Medical Association
SPS commentary:
According to a related editorial,the accumulating evidence from clinical trials suggests that e-cigarettes will likely turn out to be safe and effective tools to aid smoking cessation. However, as with all existing smoking cessation therapies, e-cigarettes are not the single or long-sought-after solution to help all or even most smokers to quit. More randomised trials are needed, enrolling larger samples and testing the devices with higher nicotine delivery that now dominate the market. Trials should compare e-cigarette devices vs other approved cessation aids but also test whether e-cigarettes might be most effective when used in combination with other cessation aids. Future trials might also consider alternative designs. Most current trials consider a short course of treatment (usually 3 months) sufficient to change a long-standing addictive behaviour permanently.It concludes that tobacco dependence is now understood to be a chronic disorder that may require long-term treatment. Following a harm-reduction approach, testing the effectiveness and, especially, the safety of e-cigarettes with longer durations of use and among individuals who are less interested in complete abstinence from nicotine should be a priority.